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, During muscle vibration (condition_noVis+Vib, 5% MVC), CD_R+ patients showed significantly reduced mean force (0.74±0.33N) compared to CD_R-patients (1.26±0.35N, p<0.001) and to control subjects (1.08±0.37N, p = 0.006). Hence, compared to control subjects, CD_R-patients tended to overshoot, whereas CD_R+ patients undershot target forces. The above ANOVA was repeated with baseline EMG activity (during rest) as covariate. This cancelled the statistical main (GROUP, p = 0.3) and post-hoc differences between CD patients and control subjects. In the force-maintaining task, the performance of CD_R-and CD_R+ patients were qualitatively similar to those seen during force-matching, However, performance of CD patients differed in conditions requiring sense of effort cues: in condition_noVis (5% MVC), force was significantly increased in CD_R-patients (1.31±0.47N) compared to control subjects (1.06±0.43N, p = 0.006), but not in CD_R+ patients (0.89±0.32N, vol.27, p.0

, However, during force-matching, the ANOVA of EMG activity showed significant effects of GROUP (F = 10.52, p<0.001) and FORCE (F = 92.63, p<0.001), but not of CONDITION (F = 0, Electromyography EMG activity during MVC was similar between groups (F = 0, vol.69, p.0

, which postulates that to control movement, subjects (through mechanisms of gating/weighting) rely on the most reliable information available among multi-modal sensory feedback. With visual force feedback, performance of CD patients was similar to that of control subjects. CD patients presumably used the most reliable sensory modality (vision) and gated less reliable feedback, EMG activity was higher in CD_R+ than in CD_R-patients, p.0

, ) by using sense of effort cues exclusively. The variability around the average force increased for all subjects. However, force control was impaired only in CD patients without retrocollis, since CD_R-patients overshot, whereas CD_R+ patients and control subjects showed no change. These results suggest that CD_R-and CD_R+ patients optimized their use of sense of effort cues differently. Presumably, CD_R+ patients favoured peripheral cues since voluntary activation of dystonic task-related muscles helped keeping agonist afferent feedback reliable. CD_R-patients may have chosen central cues since non-agonist dystonic muscles may have produced sensory afferent crosstalk, rendering the efferent copy more reliable. Baseline EMG explained Sense of effort in cervical dystonia, PLOS ONE, vol.7, issue.10, 2017.

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